Revision Anterior Cruciate Ligament Reconstruction Using a Unique Bioabsorbable Interference Screw for Malpositioned Tunnels

Revision anterior cruciate ligament (ACL) reconstruction surgery has become increasingly common. The number of primary ACL reconstructions increases each year, and athletes are often able to return to cutting and pivoting sports. Most failed ACL reconstructions result from technical errors, commonly malpositioned tunnels. Correcting such tunnels in revision surgery requires understanding anatomy, preoperative planning, and often multiple methods of addressing bony defects. Multiple options have been described for handling these bony deficiencies, many of which are technically difficult and time-consuming to correct.

We describe a simple technique for addressing a bony defect during revision ACL reconstruction using a unique bioabsorbable interference screw comprised of an osteoconductive bioceramic beta-tricalcium phosphate and poly(lactide-co-glycolide). Unique properties of this screw provide significant structural support for drilling revision tunnels through a portion of the screw or next to the screw, which allows for uncompromised tunnel placement.